Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy: do melanomas and nevi already differ at baseline?
Background: What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. Objective: To compare the grade of atypia of melanomas and nevi of the same patient at baseline. Methods: Prospective observational study using 236 dermatoscop...
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| Hauptverfasser: | , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2017
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| In: |
Journal of the European Academy of Dermatology and Venereology
Year: 2016, Jahrgang: 31, Heft: 6, Pages: 972-977 |
| ISSN: | 1468-3083 |
| DOI: | 10.1111/jdv.14065 |
| Online-Zugang: | Verlag, Pay-per-use, Volltext: http://dx.doi.org/10.1111/jdv.14065 Verlag, Pay-per-use, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.14065 |
| Verfasserangaben: | P. Tschandl, L. Hofmann, C. Fink, H. Kittler, H.A. Haenssle |
MARC
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| 245 | 1 | 0 | |a Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy |b do melanomas and nevi already differ at baseline? |c P. Tschandl, L. Hofmann, C. Fink, H. Kittler, H.A. Haenssle |
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| 520 | |a Background: What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. Objective: To compare the grade of atypia of melanomas and nevi of the same patient at baseline. Methods: Prospective observational study using 236 dermatoscopic baseline images (59 quartets from 59 patients, each including one melanoma detected during follow-up and three nevi). Dermatologists (n = 26) were asked to assess the ‘grade of dermatoscopic atypia’ on a numerical scale and to identify the melanomas. Results: On average, each dermatologist identified 24 of 59 melanomas (40%, range: 11-37). The number of correct picks was greater for dermatologists with moderate (mean: 28) or high (mean: 28) experience compared to beginners (mean 17; P < 0.001). In three of the 59 sets, none of the 26 dermatologists identified the melanoma. The mean grade of dermatoscopic atypia was 2.5 for nevi (95% CI: 2.4-2.6) and 3.0 for melanomas (95% CI: 2.9-3.1, P < 0.001). Limitations: Rating dermatologists were informed that each quartet of images included one melanoma creating substantial deviation from a real-life situation. Conclusion: A significant proportion of melanomas detected during follow-up cannot be differentiated from nevi at baseline. This necessitates the additional inclusion of less atypical lesions for monitoring. | ||
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